Effect of Physical Therapy Interventions in the Acute Care Setting on Function, Activity, and Participation After Total Knee Arthroplasty

Abstract Background The purpose of this qualitative focus group study was to explore race differences in the rehabilitation experience and satisfaction with rehabilitation following total knee arthroplasty (TKA). Methods We conducted a series of qualitative focus group discussions with groups of Non-Hispanic White and Non-Hispanic Black older adults who recently underwent TKA. We used grounded theory approach, which asks the researcher to develop theory from the data that are collected. Participants discussed barriers and facilitators to accessing rehabilitation after surgery, opinions regarding their physical therapists, the amount of post-operative physical therapy received, and overall satisfaction with the post-operative rehabilitation process. Results Thirty-six individuals participated in focus groups. Three major themes emerged: (1) Participants reported overall positive views of their post-TKA rehabilitation experience. They particularly enjoyed one-on-one care, the ability to participate in “prehabilitation”, and often mentioned specific interventions they felt were most helpful in their recovery. (2) Despite this, substantial barriers to accessing physical therapy exist. These include suboptimal pain management, copayments and other out-of-pocket costs, and transportation to visits. (3) There were minor differences in the rehabilitation experiences between Black and White participants. Black participants reported longer paths toward surgery and occasional difficulty interacting with rehabilitation providers. Conclusions Individuals undergoing TKA can largely expect positive rehabilitation experiences post-operatively. However, some barriers to post-operative physical therapy exist and may differ between Black and White patients. Physical therapists should increase their awareness of these barriers and work to minimize them whenever possible.

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The Effects of Single-Session Music Therapy Interventions in Comparison with a Cognitive Behavioral Intervention on Mood with Adult Psychiatric Inpatients in an Acute-Care Setting: A Quasi-Experimental Trial

Music Therapy Perspectives ◽

10.1093/mtp/miv030 ◽

2015 ◽

Vol 33 (2) ◽

pp. 118-127 ◽

Cited By ~ 1

Author(s):

Rachel Markovich ◽

Kazunori Tatsumi

Keyword(s):

Music Therapy ◽

Acute Care ◽

Behavioral Intervention ◽

Care Setting ◽

Acute Care Setting ◽

Cognitive Behavioral Intervention ◽

Single Session ◽

Experimental Trial ◽

Quasi Experimental ◽

Therapy Interventions

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Adapting Physical Therapy Management of Patients With COVID-19 in the Acute Care Setting

Cardiopulmonary Physical Therapy Journal ◽

10.1097/cpt.0000000000000177 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Grant D. Bitzer ◽

Karlyn Green ◽

Ricki Christopherson ◽

Sabrina Fogleman ◽

Sara Dorn ◽

...

Keyword(s):

Physical Therapy ◽

Acute Care ◽

Care Setting ◽

Acute Care Setting ◽

Therapy Management

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Prospective, Randomized Clinical Trial Comparing a Novel Motion-Assistive Device to Standard Physical Therapy for Initial Management of Knee Range of Motion after Primary Total Knee Arthroplasty

The Journal of Knee Surgery ◽

10.1055/s-0041-1735160 ◽

2021 ◽

Author(s):

James L. Cook ◽

Kylee Rucinski ◽

Cory R. Crecelius ◽

Suzin Cunningham ◽

Trent M. Guess

Keyword(s):

Clinical Trial ◽

Total Knee Arthroplasty ◽

Patient Satisfaction ◽

Physical Therapy ◽

Knee Arthroplasty ◽

Assistive Device ◽

Initial Management ◽

Prospective Randomized Clinical Trial ◽

Total Knee ◽

And Function

AbstractThis prospective randomized clinical trial assessed a novel device for initial management of knee range of motion (ROM), pain, and function after total knee arthroplasty (TKA). Primary TKA patients with preoperative ROM of at least 5° to 115° were randomized to initial knee motion management: Mizzou BioJoint Flex—novel motion-assistive device with prescribed physical therapy or standard physical therapy—prescribed physical therapy. ROM, pain score, and knee injury and osteoarthritis score for joint replacement (KOOSjr) were obtained preoperatively and 2 weeks, 6 weeks, and 3 months postoperatively. Patient satisfaction for both cohorts and subjective assessments of the MBF device were assessed at 3 months. Readmissions, reoperations, and complications were assessed through 1 year. Nineteen patients were randomized to each cohort, with no significant preoperative differences in demographics, pain score, KOOSjr score, or ROM. Six SPT (31.6%) and 3 MBF (15.8%) patients failed to regain preoperative ROM (p = 0.044). One SPT (5.3%) and eight MBF (42%) patients exceeded 125° ROM (p = 0.019) by 3 months. Total ROM (p = 0.039), pain (p = 0.0068), and function (p = 0.0027) were significantly better for MBF at 3 months. MBF patients reported significantly higher satisfaction (mean, 9.4 ± 1.1 vs. 8.0 ± 1.8, respectively; p = 0.0084). One patient in each group underwent manipulation under anesthesia. No other readmissions, reoperations, or complications were reported. A novel durable medical equipment device can provide a safe and effective patient-controlled method for initial management of knee ROM, pain, and function after primary TKA with potential clinically meaningful advantages over physical therapy alone. In conjunction with physical therapy, management with this novel knee flexion device more effectively restored knee ROM and early patient function when compared with therapy alone and was associated with higher proportions of patients regaining minimum (115°) and desired (125°) levels of knee ROM and clinically meaningful differences in pain scores, knee function, and patient satisfaction. This is a Level 1, prospective trial study.

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